How do medical health sharing groups work?


According to the new federal health care law, Patient Protection and Affordable Care Act, members of health care medical sharing groups are exempt from participating in the mandated individual health care rules that become effective in 2014.

To qualify, organizations must be nonprofits that have been in uninterrupted existence since Dec. 31, 1999. The two largest in the United States are Samaritan's Ministries and Medi-Share (Christian Care Medical Sharing)

Founded: 1993

Members: 13,000 households, covering as many as 38,000 people. It processes an average of 9,000 medical bills a month.

Monthly fee: Varied, depending on monthly need

Coverage amount: Up to $1 million annually, after a $1,250 annual household portion (similar to a deduction). The ministry has made $450 million in payouts since its inception, averaging about $3.5 million a month, its president, Robert Baldwin said.

Process: Each member opens an account through American Christian Credit Union. Doctors send member bills to Medi-Share, where the staff checks the medical charges against an established guideline list. Ministry then divides up the cost of the bill among members, who then write checks directly to the provider.

 "The money remains in the members' hands," Baldwin said.

Estimated turnover: 15 percent a year, generally caused by member getting a new job with paid insurance benefits or aging into Medicare.

Specialized program: Restore was developed six years ago to help manage members who are on higher-risk level for health, including weight, diabetes, etc. A mandated $60 fee provides the member with a health coach for three months to reduce the risk and improve health.

"Ultimately we know the best defense against the rising costs of health care is getting healthier," Baldwin said. "It's a great approach to biblical health."

More information:

Samaritan Ministries
Founded: Incorporated in 1991, began sharing in 1994

Members: 14,000 households, covering as many as 48,000 people in all 50 states

Monthly fee: $320 (up from $285 after a recent 4-1-margin vote of its membership)

Coverage amount: $350 to $250,000 annually

Process: Ministry compiles and reviews bills to match its established guidelines. Needs are then published and assigned in a monthly newsletter. Members review and send monthly share amount directly to the recipient.

Estimated turnover: 15 to 20 percent a year, generally caused by a member getting a new job with paid insurance benefits or aging into Medicare.

Specialized program: Samaritan's offers Save to Share for those members wishing to assist families whose need exceeds the $250,000 cap.

"We are to bear our own load, we are to bear our own needs, but when those burdens seem too big, we are supposed to surround each other," said Samaritan's Vice President James Lansberry.

More information:

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